In the days prior to the transition of Web interChange to the new CoreMMIS Provider Healthcare Portal, there may be a disruption of functions and information while still working in Web interChange. Please read the bulletin below paying close attention to the information given on page 3 & 4 under the “Eligibility File Updates” & “Eligibility Verification Systems” headlines. If you have any problems, please keep documentation of the issue and alert your manager.
Key Notes from the Bulletin:
- The November 30, 2016 member eligibility file from ICES will be the final eligibility update made in IndianaAIM. The update will be made by 6 a.m. on December 1, 2016. This will be the final ICES update sent to MCEs, OptumRx, and other partners until after CoreMMIS implementation.
- The first member eligibility file update in CoreMMIS will include ICES files from December 1-3, 2016, and will occur by 6 a.m. on December 5, 2016, before CoreMMIS implementation. This ICES update will also be sent to MCEs, OptumRx, and other partners.
- IHCP eligibility verification systems will be operational throughout the transition; however, eligibility information will not reflect updates made on December 1-3, 2016, until after CoreMMIS implementation.
- Providers are encouraged to maintain documentation of all eligibility results they receive for verifications conducted during the time frame ICES updates are suspended. Providers are also encouraged to REVERIFY eligibility after CoreMMIS is implemented and eligibility files are again up-to-date. Providers should contact their HPE Provider Relations field consultant if discrepancies are identified.
- Eligibility verification systems will be affected only in the hours immediately before CoreMMIS implementation; interruptions will be kept to a minimum.
- The Automated Voice Response (AVR) system is expected to be available until 6 p.m. on December 4, 2016.
- EDI eligibility transactions are expected to be available until 12 midnight December 4, 2016.
- Web interChange is expected to be available for eligibility verification throughout the transition. This functionality will be disabled on Web interChange as of 6 a.m. on December 5, 2016, at which point eligibility verification will be available through the Portal.
- Presumptive eligibility (PE) – Functionality for processing PE applications will remain available to qualified providers (QPs) throughout the transition. When the Portal begins processing PE applications, this function will be disabled in Web interChange. The transition of processing PE applications from Web interChange to the Portal will occur between 12 midnight and 6 a.m. on December 5, 2016.
Read the full bulletin here.